Beacon Medical Group, Inc

Organization Cardiovascular Disease Physician · NPI 1487061131

Beacon Medical Group, Inc provides Cardiovascular Disease Physician services in Lagrange, Indiana. Registered with an NPI since 2014.

In the registry since: 2014

What do these letters mean?

Inc — Incorporated: A form of business registration, not a clinical qualification.

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Practice location Address checks out

2400 N Ventura Way
Lagrange, IN 46761-4101 Not confirmed with CMS for 10 years — call before visiting
Phone: (574) 524-7123
Fax: (574) 296-6522

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary)	Taxonomy 207RC0000X

Record details

NPI number	1487061131
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Jeffrey Costello — Cfo · (574) 647-3549
Other names	Beacon Medical Group Lagrange Specialty Clinic
NPI enumerated	July 15, 2014
Last updated in NPPES	August 30, 2016
Mailing address	710 N Niles Ave, South Bend, IN 46617-1924